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Northwest Portland Area Indian Health Board

Legislative and Policy Update

May 9, 2023

Important Dates

May 7-11, 2023

Affiliated Tribes of Northwest Indians Midyear Convention

— Coeur d’Alene Casino

Registration Link


May 9-11, 2023

Portland Area Facilities Advisory Committee Meeting

— Portland, OR; Hybrid

May 9, 2023 (12:00 PM PST)

MMPC Monthly Meeting


May 10, 2023 (9:00 AM PST)

VA Health Subcommittee Meeting

— Virtual


May 10, 2023 (10:30 AM PST)

IHS Tribal Consultation on Health IT Modernization Resources

Registration Link


May 10, 2023 (11:30 AM PST) - CANCELLED

CMS TTAG Conference Call


May 11, 2023 (9:00 AM PST)

ACF/IHS/SAMHSA Interagency Webinar on Children’s Behavioral Health: Best Practices in Tribal Communities — Early Childhood and School-based Programs

May 12, 2023 (9:00 AM PST)

ACF/IHS/SAMHSA Interagency Webinar on Children’s Behavioral Health: Best Practices in Tribal Communities — Whole Family and Workforce Programs

May 15, 2023 (2:00 PM PST)

Tribal Health Director Learning Collaborative

May 16, 2023 (10:00 AM PST)

New Hepatitis B Screening Recommendations Webinar

Registration Link

May 17, 2023 (11:00 AM PST)

HHS Office of Civil Rights Tribal Consultation re Reproductive Health

Registration Link


May 17, 2023 (12:00 PM PST)

CMS All Tribes Webinar on Medicare Inflation Rebates and Negotiations

Registration Link

May 17-18, 2023

Direct Service Tribes Advisory Committee (DSTAC) 3rd Quarter Meeting — Richmond, VA

May 22-23, 2023

Washington State Tribal Opioid Fentanyl Summit

— Lummi Nation

May 23, 2023 (1:30 PM PST)

Region 10 Conversation on Equity: Addressing the Maternal Health Crisis

Registration Link


May 24, 2023 (11:00 AM PST)

CMS All Tribes Webinar Re-envisioning Quality Improvement Through a Community-Centered Lens

Registration Link


May 26, 2023 (11:00 AM PST)

ISAC Monthly Meeting

Jun 1-2, 2023

IHS Director’s Advisory Workgroup on Tribal Consultation

Jun 2, 2023 (11:00 AM PST)

OMB Virtual Tribal Consultation on IHS Mandatory Funding Proposal 

Registration Link

Jun 4-9, 2023

NCAI Mid-Year Conference

Prior Lake, MN

Jun 7-8, 2023

CMS Health Equity Conference

— Washington D.C.; hybrid 

Conference Link

Health News & Notes

Spring Edition

Check out the Behavioral Health edition of the Health News & Notes quarterly journal. This issue features comments from Chairman Nickolaus D. Lewis and information on the upcoming summer youth delegate opportunities.

Read the Publication Here
Visit our FHACT Tracker

Federal Health Agency and Congress Tracker (FHACT) An ongoing list of Dear Tribal Leader Letters, Federal agency actions, and legislation introduced in the 117th Congress related to health.

COVID-19 Funding Tracker

An ongoing tracker of COVID-19 direct and set-aside funding for Tribes. Updated as of Aug. 2, 2021.

Legislation & Appropriation Updates

Special Diabetes Program for Indians (SDPI) Reauthorization Act of 2023, H.R. 2547, introduced by Rep. Tom Cole (R-OK-04) and Rep. Raul Ruiz (D-CA-36).  This bill would reauthorize SDPI at $150 million annually for 5 five fiscal years.  SDPI Congressional member sign-on letters are available.  Urge your representative to join the letter!

  • To view the Congressional sign-on letter for the Senate, click here
  • To view the Congressional sign-on letter for the House, click here. 

Assistant Secretary for Indian Health within HHS, H.R. 2535 reintroduced in the 118th Congress by Rep. Stanton (D-AZ) and Rep. Joyce (R-OH).  This bill would elevate the current position of the Director of the Indian Health Service to Assistant Secretary for Indian Health within HHS.  This bill was referred to the House Committee on Natural Resources and then to the Committee on Energy and Commerce.

House Passes “Limit, Save, Grow Act of 2023” 217 to 215 is a debt limit and spending reductions package. This Act returns discretionary spending to FY 2022 levels, including the Indian Health Service, which would be a $327 million cut; expand work requirements for Medicaid, SNAP, and TANF; rescind unused COVID relief funds; and other policy-related cuts.  

President Biden Releases Budget Request for FY 2024. The Biden Administration’s proposed FY 2024 includes $8.1 billion for the Indian Health Service (IHS) and $250 million in mandatory funding for Special Diabetes Program for Indians (SDPI).  The Administration also proposes mandatory funding for all IHS accounts starting in 2025 that would grow automatically each year based on inflation, key operational needs, and existing backlogs in health care services and facilities infrastructure.  IHS program increases in the budget request for FY 2024 include +$181 million for PRC, + $37 million for mental health, +$42 million for alcohol and substance abuse, and + $20 million for CHAP.  

  • The President’s Budget Request also includes the reauthorization of SDPI at $250 million in FY 2024, $260 million in FY 2025, and $270 million in FY 2026.  

Senate Appropriations Subcommittee on Interior, Environment, and Related Agencies releases outside witness testimony instructions for FY 2024 appropriations. The Indian Health Service budget is within the jurisdiction of the Interior Subcommittee. Testimony is due May 24, 2023.  

Tribal Consultation, Listening Session & Written Comment Updates

Indian Health Service (IHS) Health IT Modernization Tribal Consultation. IHS is hosting the second consultation out of four sessions on May 10 at 10:30 AM PT.  This session will focus on resources, including funding for health IT modernization.  NPAIHB will host a Northwest Caucus soon to prepare written comments.  

Health and Human Services (HHS) Office of Civil Rights (OCR) Tribal Consultation. HHS OCR is hosting tribal consultation on May 17 at 11 AM PT to receive input from Tribes on a proposed rulemaking prohibiting the disclosure or use of protected health information for limited purposes when obtaining, providing, or facilitating reproductive healthcare.   

Office of Management and Budget (OMB) Tribal Consultation on the President’s Mandatory Funding Proposal for the IHS. OMB will conduct a virtual tribal consultation on the President's mandatory funding proposal for the IHS on Jun. 2, 2023, at 11 AM PT.   

Administration for Community Living (ACL) Tribal Consultation and Listening Session. ACL will be hosted a hybrid tribal consultation and listening session on long-term services and supports, providing home and community-based services, transportation access, and Title VI funding and services to tribal elders.  

HHS Annual Tribal Budget Consultation. Last month, HHS hosted the Annual Tribal Budget Consultation for Tribes to share their views and priorities with HHS officials on national health and human services funding priorities and make recommendations on HHS's FY 2025 budget request. 

Administrative and Regulatory Updates

Executive Order 14096, Revitalizing Our Nation’s Commitment to Environmental Justice for All. President Biden issued EO 14096 to advance environmental justice for all “by implementing and enforcing the Nation’s environmental and civil rights laws, preventing pollution, addressing climate change and its effects, and working to clean up legacy pollution that is harming human health and the environment.”  The EO establishes the White House Office of Environmental Justice within the Council on Environmental Quality, which is directed to oversee the development of policies, programs, and partnerships to advance environmental justice and to identify opportunities to collaborate with Tribes, states, and local governments. 

COVID-19 Public Health Emergency (PHE) Will End on May 11, 2023. On Feb. 9th, Secretary Becerra announced that the COVID-19 PHE declaration will end on May 11, 2023. The Office of Civil Rights also announced the end of its enforcement discretion under the Health Insurance and Portability and Accountability Act of 1996.  Healthcare providers will have 90 calendar days to comply with the privacy rules for their telehealth services. 

IHS Website for Sanitation Facilities Construction Projects.  IHS Division of Sanitation Facilities Construction Projects launched a new website that includes the status of all sanitation facilities projects funded with the Bipartisan Infrastructure Law.   

$2.5 Million for Produce Prescription Programs in Indian Country. A new funding opportunity is available through the IHS to develop and produce prescription programs in Tribal communities.  Applications are due June 8, 2023.  

The Administration for Children and Families (ACF) proposes eliminating cost share for Tribal Child Support Enforcement Programs.  ACF has published a notice of proposed rulemaking that would eliminate the non-Federal cost share for Tribal child support enforcement programs, including the 90/10 and 80/20 cost-share rates. Written comments on this proposed rule are due Jun. 20, 2023.

  • Submit written comments through the Federal eRulemaking Portal HERE using Regulatory Information Number 0970-AC99.


CDC Director Rochelle Walensky Announces her Departure from the Agency.  The White House announced that Director Walensky will leave the Agency on June 30.  She has served as agency director for two years and guided the Biden Administration on the COVID-19 response since he took office.  

CDC Launches a New Tribal Public Health Data Site. The CDC has launched an online Tribal Public Health Data site to assist tribal partners and others with information and tools related to tribal data. The site guides accessing CDC tribal data; information on tribal data issues, tools, technical assistance, and training; and tribal data-related resources from public health partners. This site will continue growing as CDC further engages with tribes and tribal organizations to provide the most needed data-related information.

National Indian Health Board Report Released - Health Equity in Indian Country: Rethinking how CMS Approaches Health Equity for American Indian and Alaska Native People

Medicare Prescription Drug Inflation Rebate Program. CMS announces lower coinsurance for individuals with Medicare Part B coverage for 27 certain prescription drugs that will go into effect on Apr. 1, 2023.   The list of Part B drugs this rebate applies to is available HERE.  CMS will host an All Tribes webinar on this new Medicare Prescription Drug Inflation Rebate Program and Medicare Drug Price Negotiation Program on May 17 at 12 PM PT. Registration link for All Tribes Webinar available here.

CMS Issues State Health Official Letter Discussing 'Unwinding.' CMS released a State Health Official (SHO) letter outlining new requirements in the Consolidated Appropriations Act, 2023 that impact state activities for the Medicaid and CHIP programs to unwind from the COVID-19 public health emergency.  As of April 1, 2023, states are no longer required to maintain continuous Medicaid enrollment to receive the temporary FMAP increase.  

HRSA Webinar on New Hepatitis B Screening Recommendations. On May 16, 2023, at 10 AM PT, HRSA will host a webinar to brief clinicians and other healthcare providers on the new recommendations for hepatitis B screening and testing.

Office of Inspector General (OIG) Compliance Program Guidance Documents. OIG announces modernization of Compliance Program Guidances (CPG) that includes: publishing general CPG on federal fraud and abuse laws, compliance program basics, operating effective compliance programs, and OIG processes and resources for all individuals and entities; publishing industry-specific CPGs for providers, suppliers, and other participants in the healthcare industry or other sectors related to Federal health care programs.  These updated guidances will no longer be available on the Federal Register but on the OIG website.    

SAMHSA Announces Removal of DATA Waiver Requirement to Prescribe Buprenorphine. Clinicians can now prescribe medications for the treatment of opioid use disorder without submitting a Notice of Intent (Waiver) to SAMHSA.  

VA Adds Chiropractic Services to Covered Medical Benefits. The VA has amended its regulations to add chiropractic services to its medical benefits package, effective May 22, 2023.

VA Releases Final Rule on Co-Payment Exemption for Indian Veterans. The VA released the final rule to implement co-payment exemptions for Indian and urban Indian veterans for hospital care or medical services received on or after January 5, 2022.  

VA Publishes Brochure on Resources for Native American Veterans Experiencing Homelessness. The new brochure was developed as part of the multi-agency Native American Veteran Homelessness Initiative with the IHS that seeks to increase access to care and services for Native veterans experiencing or at risk of homelessness. The brochure includes 24/7 confidential counselor telephone lines and an overview of the services available through the VA. These include housing, healthcare, case management, employment, and legal support programs. 

Tribal Health-related Funding Opportunities

HRSA Maternal and Child Health Bureau Funding Opportunities. A suite of HRSA grants currently exists that focus on providing resources to improve maternal health outcomes. Tribes and Tribal organizations are eligible to apply for the following:

  • The Alliance for Innovation on Maternal (AIM) Health Capacity to implement patient safety protocols and expand the implementation and quality of maternal serving programs. A separate AIM Technical Assistance grant is available to support facilities participating in the program. Both applications close on May 9.
  • The Integrated Maternal Health Services initiative fosters the development and demonstration of integrated health services models to improve maternal health outcomes through increased access to comprehensive, quality care. Data health infrastructure is a component of this grant. Applications are due by May 24.

SAMHSA Tribal Behavioral Health (Native Connections) Grant.  The purpose of this program is to prevent and reduce suicidal behavior and substance use/misuse, reduce the impact of trauma, and promote mental health among American Indian/Alaska Native (AI/AN) youth, up to and including age 24, by building a healthy network of systems, services, and partnerships that impact youth.  The length of the project is up to 5 years and an anticipated award amount of $250,000.  

HHS Announces $2.5 Million for Produce Prescription Programs in Indian Country. The U.S. Department of Health and Human Services, through the Indian Health Service agency, is announcing the availability of $2.5 million in funding to support the development of produce prescription programs in Native communities. Produce prescription programs help individuals and families experiencing food insecurity and/or diet‑related health problems more easily obtain fresh fruits and vegetables by receiving a prescription from a health care provider. Eligible applicants include tribes, tribal organizations, and urban Indian healthcare organizations. 

  • Applications are due by Jun. 8, 2023. Approximately 4 to 7 awards will be issued under this program announcement for a performance period of five years.

IHS Releases 2023 Request for Applications on Addressing Dementia in Indian Country: Models of Clinical Care and Support. The Program Award aims to 1) improve recognition, diagnosis, assessment, and care management for persons living with dementia (PLWD) and 2) improve care and access to dementia caregiver services and support for Tribes receiving primary health care services from IHS Direct Services. 

  • Applications are due Jun. 12, 2023, with an anticipated project start date of Aug 1, 2023. 
  • Learn more about the opportunities here:

ACF Children’s Bureau State-Tribal Partnerships to Implement Best Practices in Indian Child Welfare. This Notice of Funding Opportunity will support nine demonstration sites that promote coordinated efforts among State courts, child welfare agencies, and Tribes to develop and implement best practices related to AI/AN child placements. All three entities must participate in the five-year grant. Partnerships should collaborate on culturally appropriate practices, preventing maltreatment, and improving safety, permanency, and well-being. This can include Indian child welfare codes, legal processes, case management, in-home preservation services, systems changes, and the development of pilot models to test. Applications are due by Jun. 13, 2023.

For more information:

Laura Platero, Executive Director 

Liz Coronado, Senior Policy Advisor

Candice Jimenez, Health Policy Analyst

Northwest Portland Area Indian Health Board | Website